BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ANIMAS VIBE

    MDR report key: 5568977 · Received April 11, 2016

    Report

    Report Number
    2531779-2016-07618
    Event Type
    Malfunction
    Date Received
    April 11, 2016
    Report Date
    March 24, 2016
    Manufacturer
    ANIMAS CORPORATION
    Product Code
    MDS
    PMA / PMN Number
    P130007
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    SUBMITTED: (B)(6) 2016. THE PUMP HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON 03/24/2016 WITH THE FOLLOWING FINDINGS: DEVICE EVALUATION: ON INVESTIGATION, THE BATTERY COMPARTMENT WAS NOTED TO BE CRACKED BELOW THE BUMPER PAD AND THE DISPLAY SCREEN WAS FOUND TO BE DISCOLORED.

    Description of Event or Problem · 1

    THE PUMP WAS RETURNED FOR INVESTIGATION. INVESTIGATION REVEALED A DISPLAY DEFECT AND BATTERY COMPARTMENT DAMAGE. THIS REPORT IS MADE BASED ON RESULTS OF INVESTIGATION COMPLETED ON 03/24/2016.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    224056 ANIMAS VIBE INSULIN INFUSION PUMP MDS ANIMAS CORPORATION

    Patients

    Seq Age Sex Outcome Treatment
    1